![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by LostBoyinNCReturns on March 13, 2012, at 23:41:48
Ive found I can tolerate 50 mg zoloft fine, but only if I take blood pressure meds and a lot of klonopin with it. If I take 100 mg Z for more than two days, I start getting increased blood pressure, chest pains, blurred vision, agitation, some mild irritatibility and have to stop and go back to 50 mg.
Ive been told this is "activation syndrome." Im not so sure because before I developed high blood pressure I used to be able to tolerate all these meds at real high doses easily. But after I developed hypertension, it has become like an SSRI is like speed almost. The stuff makes me feel like Im gonna have a heart attack or something. For real.
I dont know whether to believe the reaction I have is true SSRI "activation syndrome" or just a change in my body after I developed hypertension, and my body will only tolerate but so much stimulating medication to protect my blood vessels and heart from increased blood pressure.
But if it is activation syndrome, what causes it and what does it mean?
thanks,Eric
Posted by SLS on March 14, 2012, at 1:35:36
In reply to What is 'SSRI activation syndrome?', posted by LostBoyinNCReturns on March 13, 2012, at 23:41:48
> Ive found I can tolerate 50 mg zoloft fine, but only if I take blood pressure meds and a lot of klonopin with it. If I take 100 mg Z for more than two days, I start getting increased blood pressure, chest pains, blurred vision, agitation, some mild irritatibility and have to stop and go back to 50 mg.
>
> Ive been told this is "activation syndrome." Im not so sure because before I developed high blood pressure I used to be able to tolerate all these meds at real high doses easily. But after I developed hypertension, it has become like an SSRI is like speed almost. The stuff makes me feel like Im gonna have a heart attack or something. For real.
>
> I dont know whether to believe the reaction I have is true SSRI "activation syndrome" or just a change in my body after I developed hypertension, and my body will only tolerate but so much stimulating medication to protect my blood vessels and heart from increased blood pressure.
>
> But if it is activation syndrome, what causes it and what does it mean?I can't answer your question. I have never heard of this syndrome. I guess you learn something new every day. You could try lowering the dosage of Zoloft to 25 mg. You could try discontinuing the Zoloft completely. Perhaps you don't need it anymore. You could try switching to another drug, even another SSRI. You could remain on Zoloft and try adding propranolol to mitigate the autonomic symptoms.
I'll probably investigate the "SSRI activation syndrome" more tomorrow. It almost sounds like the behavioral disinhibition reaction seen with alcohol and benzodiazepines.
- Scott
Posted by creepy on March 14, 2012, at 8:58:21
In reply to What is 'SSRI activation syndrome?', posted by LostBoyinNCReturns on March 13, 2012, at 23:41:48
sounds like panic symptoms. At that dose zoloft probably isnt doing anything to dopamine, but you -may- have metabolic issues that mean youre effectively taking more than 50.
Its a pretty activating drug for many. Lots of reports of akathisia as well. That can be mistaken for anxiety and result in an increased dose from the doc.
if you need an antidepressant try something less activating like celexa?
Posted by Phillipa on March 14, 2012, at 10:26:22
In reply to Re: What is 'SSRI activation syndrome?', posted by creepy on March 14, 2012, at 8:58:21
I'd like to also know what it is. Phillipa
Posted by LostBoyinNCReturns on March 14, 2012, at 11:07:21
In reply to Re: What is 'SSRI activation syndrome?', posted by creepy on March 14, 2012, at 8:58:21
> sounds like panic symptoms. At that dose zoloft probably isnt doing anything to dopamine, but you -may- have metabolic issues that mean youre effectively taking more than 50.
> Its a pretty activating drug for many. Lots of reports of akathisia as well. That can be mistaken for anxiety and result in an increased dose from the doc.
> if you need an antidepressant try something less activating like celexa?I do have a formal diagnosis of SSRI induced akathisia from way on back, when this whole thing started. I'd take antidepressants (SSRIs) and the first week had so many side effects I felt like I was going out of my mind. A few months later, I got a second opinion with some bigshot Pdoc at Duke and found out I was having "SSRI induced akathisia." In fact, Ive got the psychiatric record now, have had it for years actually, that say I have those side effects from SSRIs.
I dont get that from Remeron btw. So I bet it is akathisia. And it got ten times worse after I developed hypertension problems. I tolerate 50 mg zoloft just fine so long as I take my blood pressure med and klonopin, but like I said, I try to push it past 50 and Lordy, my chest feels like it is gonna blow a valve. It is actually painful.
Eric
Posted by LostBoyinNCReturns on March 14, 2012, at 11:23:23
In reply to Re: What is 'SSRI activation syndrome?', posted by Phillipa on March 14, 2012, at 10:26:22
> I'd like to also know what it is. Phillipa
It is basically akathisia type symptoms. It feels like you start the SSRIs and instead of nothing happening for a month, you feel awful for a while.
50 mg Benadryl smooths it out for a day, I dont get it at all on the antidepressant Remeron. I dont get it from formal stimulants like Provigil or Ritalin, either.
I used to just "force myself thru it" before hypertension. Now with high blood pressure, Im finding I cant do that anymore.
Eric
Posted by SLS on March 14, 2012, at 12:10:42
In reply to Re: What is 'SSRI activation syndrome?', posted by creepy on March 14, 2012, at 8:58:21
Hi Creepy.
> Lots of reports of akathisia as well.
Is Zoloft more apt to do this than the other SSRIs? What about Paxil?
- Scott
Posted by creepy on March 15, 2012, at 7:08:05
In reply to Re: What is 'SSRI activation syndrome?' » creepy, posted by SLS on March 14, 2012, at 12:10:42
From what Ive seen zoloft and prozac are the worst offenders if you are susceptible to this effect.
I got it on both meds.
Anxiety or akathisia? sometimes hard to tell apart and Im not an expert. Still, not a pleasant experience whatever it was =(
Posted by LostBoyinNCReturns on March 15, 2012, at 10:25:14
In reply to Re: What is 'SSRI activation syndrome?', posted by creepy on March 15, 2012, at 7:08:05
> From what Ive seen zoloft and prozac are the worst offenders if you are susceptible to this effect.
> I got it on both meds.
> Anxiety or akathisia? sometimes hard to tell apart and Im not an expert. Still, not a pleasant experience whatever it was =(
>The bigshot Pdoc written diagnosis says on old psych records I have from Duke "has tendency to get akathisia from SSRIs."
Eric
Posted by RiFi on March 16, 2012, at 6:05:13
In reply to What is 'SSRI activation syndrome?', posted by LostBoyinNCReturns on March 13, 2012, at 23:41:48
Hi Eric,
The symptoms you've described sound like Serotonin Syndrome (I experienced it earlier this week and it ain't fun!) It occurs when too much serotonin is released into and/or remains in the brain. It typically occurs when the dosage of an SSRI or SNRI is increased, or when it's combined with another drug (lithium in my case, but it can happen with many other psych meds, pain killers, cough medicine, supplements, herbs etc)
If you look it up at 'pubmed health' you'll see that the symptoms are very close to what you described:
Agitation or restlessness
Anxiety
Diarrhea
Fast heart beat
Increased body temperature (fever, sweating)
Loss of coordination
Nausea
Overactive reflexes
Rapid changes in blood pressure
Vomiting
Hypomania
Muscle spasms (including general stiffening and soreness of muscles - flu-like, viral symptoms)
Posted by LostBoyinNCReturns on March 17, 2012, at 9:44:29
In reply to Re: What is 'SSRI activation syndrome?', posted by RiFi on March 16, 2012, at 6:05:13
> Hi Eric,
>
> The symptoms you've described sound like Serotonin Syndrome (I experienced it earlier this week and it ain't fun!) It occurs when too much serotonin is released into and/or remains in the brain. It typically occurs when the dosage of an SSRI or SNRI is increased, or when it's combined with another drug (lithium in my case, but it can happen with many other psych meds, pain killers, cough medicine, supplements, herbs etc)
>
> If you look it up at 'pubmed health' you'll see that the symptoms are very close to what you described:
>
> Agitation or restlessness
> Anxiety
> Diarrhea
> Fast heart beat
> Increased body temperature (fever, sweating)
> Loss of coordination
> Nausea
> Overactive reflexes
> Rapid changes in blood pressure
> Vomiting
> Hypomania
> Muscle spasms (including general stiffening and soreness of muscles - flu-like, viral symptoms)Actually, I dont think I am getting serotonin syndrome when I increase the dose. I think you have to take the background context into take, I "activation" when I just take 50 mg zoloft if I dont take klonopin and blood pressure meds at the same time. And I did not used to get the side effects nearly as bad before I developed high blood pressure. And I do have the akathisia diagnosis from a good Neuropsychiatrist. And akathisia has nothing at all to do with serotonin syndrome, although the symptoms are similar...restlessness, having to move, anxiety, "activation," etc.
I also know that 50 mg benadryl (an anti-cholinergic used to combat akathisia and mild EPS symptoms) decreases the side effects I get if I try to increase the zoloft.
It is complicated, it really is. I really wish these psychiatrists had formal blood testing and better diagnostic methods to prevent situations like I am describing.
later,
Eric
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.